In a recent study published in the International Journal of Obesity, researchers assessed the effectiveness of semaglutide dosages between 0.25 and 2.4 mg in overweight or obese people for up to one year.
Specifically, they assessed whether its use was safe and improved weight loss, metabolic, and comorbidity outcomes, including 10-year atherosclerotic cardiovascular disease [ASCVD] risk.
Study: Weight loss and cardiovascular disease risk outcomes of semaglutide: a one-year multicentered study. Image Credit: myskin/Shutterstock.com
Background
Obesity affects around 650 million adults globally, which has increased the burden of associated comorbidities, resulting in substantial morbidity and mortality.
Anti-obesity medications (AOMs) in conjunction with lifestyle modifications have consistently shown superior weight loss outcomes than lifestyle-targeted interventions alone.
For instance, randomized clinical trials (RCTs) on semaglutide, a Food and Drug Administration (FDA)-approved AOM, have shown superior weight loss outcomes for semaglutide than other AOMs.
Yet, only some real-world studies have assessed outcomes of semaglutide use over more than six months, limiting its clinical use.
About the study
The present retrospective study was conducted across all Mayo Clinic Hospitals in Florida, Minnesota, and Arizona in the US among patients with BMI ≥ 27 kg/m2 who were prescribed weekly subcutaneous semaglutide injections between January 1, 2021, and January 15, 2023, for weight loss.
They obtained their metabolic, clinical, and laboratory data at baseline, three, six, nine-, and 12-month follow-ups. The prescribed doses of semaglutide were 0.25, 0.5, 1, 1.7, 2, or 2.4 mg.
In-person and virtual visits and physician-patient communication through electronic medical records (EMR) enabled data collection within 30 days of these time points.
Data collected was weight using calibrated scales, laboratory results for fasting blood glucose [FBG], lipid panel, glycosylated hemoglobin [HbA1c], blood pressure [BP] readings, and liver function tests [LFTs].
The team also assessed all obesity comorbidities, type-2 diabetes mellitus (T2DM), CVD, dyslipidemia, gastroesophageal reflux disease (GERD), non-alcoholic fatty liver disease (NAFLD), and obstructive sleep apnea (OSA), depression/anxiety, and their medications taken at baseline and last follow-up.
In addition, they documented side effects associated with semaglutide use and the number of visits with bariatric psychologists/dietitians.
This study's primary endpoint was total body weight loss percentage (TBWL%) 12 months after the semaglutide start date.
Secondary endpoints were the percentage of patients attaining ≥5, 10, 15, and 20% weight loss and improvements in metabolic, cardiovascular, and comorbidities after 12 months of follow-up.
The statistical analyses involved a matched paired t-test to analyze the primary endpoint.
In addition, the team used a multivariate logistic regression model to determine weight loss post-bariatric psychologist/dietician visits accounting for T2DM status and setting the statistical significance of 2-sided P at <0.05.
Results
A total of 1,023 patients received semaglutide prescriptions for obesity. However, this analysis encompassed 304 patients, of which 73% were female and 93% were of White ethnicity.
The mean age of the included participants was 48.8 years, and they had a mean BMI of 40.9 kg/m2.
Patients achieved a TBWL of 5.7% at three, 9.7% at six, 12.7% at nine, and 13.4% at 12 months, with 22% of patients achieving weight loss of ≥20%.
At 12 months, patients without T2DM achieved a higher TBWL than patients without T2DM (16.9 vs. 9.9).
Likewise, patients on higher doses of semaglutide achieved a higher TBWL than patients taking lower doses at all time points.
Furthermore, patients with obesity experienced significant improvements in metabolic, lipid profile, blood pressure, liver function tests, and CVD outcomes.
Notably, 10-year ASCVD risk declined in patients with no history of CVD at one-year follow-up: 8.% to 6.7%.
Even though more than 50% of patients experienced side effects, mainly gastrointestinal symptoms, it required stopping semaglutide use or dose mitigation in only ~16% of the patients, showing that this drug is well-tolerated, which is crucial for chronic weight management.
Conclusions
Overall, semaglutide administration resulted in notable improvement in obesity, metabolic, and CVD risk outcomes among obese patients in a clinical setting.
Future trials should evaluate body weight changes over longer follow-up periods after stopping this medication.
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